What does a growing hospital pharmacy workforce mean for the rest of the profession?

It is no secret that NHS hospital staff are facing increasing pressures. An ageing population and increases in mental health and long-term conditions mean patients are presenting with more complex healthcare needs, leading to rising prescriptions and the need to discharge patients as quickly as possible. 

Data published by NHS England reveal hospital admissions have grown 16% over the past ten years, from 15.9 million admissions in 2014/2015 to 18.5 million in 2024/2025^​1​.

Naturally, these increased pressures mean pharmacists across the sector also face growing demands, with NHS data showing the number of prescriptions dispensed in the community has risen by 17% over the past decade.

And there are only plans for pharmacist responsibilities to grow, with the NHS ten-year plan, published in July 2025, depicting expanding clinical roles for pharmacists^​2​. This move towards advanced clinical practice was set in motion in 2023 with the development of accreditation courses by the then Royal Pharmaceutical Society and NHS England. 

Pharmacists are now often based on wards, prescribing medicines and conducting medication reviews. According to NHS workforce data, between June 2023 and March 2026, the number of full-time equivalent (FTE) pharmacist advanced practitioners increased from 11 to 202, while the number of FTE pharmacist consultants increased from 1 to 47.

“Pharmacy teams already play a well‑established clinical role, and the workforce continues to adapt to meet rising patient admissions and increasingly complex care needs,” says Amandeep Doll, director for England at the Royal College of Pharmacy.

“As the NHS looks to deliver more care closer to home and improve access for patients, pharmacists are taking on broader responsibilities in many settings, including prescribing, medicines optimisation, management of long-term conditions and supporting the safer use of medicines.”

From September 2026, all newly qualified pharmacists will register as independent prescribers, creating opportunities for their roles to develop even further. 

With ever-growing demands, will growth in hospital pharmacy teams keep pace and what does it mean for other parts of the sector?

Getting the data

To get a picture of what is happening in hospital pharmacy teams, The Pharmaceutical Journal sent a Freedom of Information (FOI) request to NHS trusts and health boards in England, Scotland and Wales, asking for their pharmacy team headcount and FTEs each year for the past five years, from 2020/2021 to 2024/2025.

Data provided by 100 trusts show that headcount and FTE among pharmacy teams has grown by 11% between 2020 and 2025 (see Figure).

Figure: Headcount for 100 NHS trusts in 2020 and 2025

Owing to the different sizes of NHS trusts, the data varied widely, with some trusts showing major growth.

For example, over the past five years, the headcount at North East London NHS Foundation Trust has grown by 100%, from 46 in 2020/2021 to 92 in 2024/2025. In the same time period, FTE increased by 89%, from 45.6 to 86.3. 

The growth resulted from a significant transformation to its pharmacy service, which was driven by bringing its dispensary service in-house and expanding its clinical pharmacy provision into community mental health, learning disability and home treatment teams, as well as growth in inpatient wards and crisis teams. 

Sussex Community NHS Foundation Trust also shows major growth, with a 90% increase in headcount and 87% increase in FTE over the past five years.

A spokesperson for the trust says: “Under the leadership of our chief pharmacist, our pharmacy workforce has grown significantly over the past five years, driven by a combination of successful commissioning and service development. 

“This includes bringing pharmacy services in-house, expanding support to virtual wards, and delivering the award-winning Medicines Optimisation in Care Homes service across Sussex. We’ve also invested in training future pharmacists and pharmacy technicians. Together, this reflects our commitment, as a community trust, to innovative, patient-centred care and the growing role pharmacy teams play in supporting the wider health system.”

Kent and Medway NHS Trust has expanded by 86% in headcount over the past five years, while FTE has increased 107%.

A spokesperson for the trust says the growth is the result of service development, organisational changes and the growing contribution of pharmacy roles.

“Pharmacy support has expanded across community mental health teams, inpatient wards and specialist services, including early intervention for psychosis, perinatal community mental health and mental health of learning disability services.

They add: “The scale and complexity of services delivered by the trust has also increased during this period, requiring additional pharmacy capacity to support patients and clinical teams. More recently, the trust has taken on responsibility for children and young people who need specialist mental health support, as well as all age eating disorders service, further increasing demand for specialist pharmacy expertise.”

Jag Bahia, chief pharmacist at Kent and Medway Mental Health NHS Trust, says: “Pharmacists and pharmacy technicians are making an increasingly important contribution across our services, ensuring patients receive the safest and most effective use of medicines while supporting multidisciplinary teams to deliver high-quality care.

“The development of our pharmacy workforce has strengthened clinical leadership, professional governance and access to specialist medicines expertise across the trust. It has also helped release valuable clinical time for other healthcare professionals, enabling them to focus on patients with the most complex needs while ensuring people continue to receive timely, expert support with their medicines.”

A spokesperson for Cornwall Partnership NHS Trust, which has seen an 80% increase in headcount and 92% increase in FTE over the past five years, says: “Over the past five years, growth in our pharmacy workforce has been driven by changes in how we deliver care and the increasing complexity of patients’ needs.

“We are now supporting more people with higher acuity, including through short-stay urgent care models, which require timely medicines optimisation and seven-day support to ensure safe, effective and timely care. 

“Alongside this, in recognition of the important role pharmacists play in our multidisciplinary teams, we have adopted a “grow our own” approach, developing pharmacists, pharmacy technicians and new roles, to build a sustainable workforce for the future.”

Other parts of the sector

This growth in hospital pharmacy teams comes just as the NHS long-term plan emphasises a shift from hospital care to the community, with community pharmacists expected to play a role in a neighbourhood health service^​2​.

However, data for the community pharmacy workforce paint a different picture to hospitals.

Results from NHS England’s 2025 ‘Community pharmacy workforce survey’ show the number of pharmacists working in community pharmacies in England dropped by 10% between 2024 and 2025, from 28,763 to 25,822 pharmacists.

Further analysis by the Pharmacists’ Defence Association suggests the number of FTE community pharmacists has declined from 20,255 in 2021 to 17,415 in 2025, with the average number per pharmacy declining from 1.80 in 2021 to 1.66 in 2025.

“It has been widely recognised for many years that NHS activity and resources need to be moved away from expensive secondary care and into preventative and primary care settings,” says Malcolm Harrison, chief executive of the Company Chemists’ Association, which represents community pharmacy operators in England, Scotland and Wales. 

“Unfortunately, almost every measure of prioritisation and funding points in the other direction.”

Referring to The Pharmaceutical Journal’s hospital pharmacy workforce figures, Harrison says: “We can now see the funding and resources that could and should be invested in community pharmacies being used to fund additional capacity in hospitals.” 

“At a time when community pharmacy is being asked to play a greater role in delivering frontline NHS care, the community pharmacy workforce has faced significant challenges, including workforce declines in some areas, recruitment pressures linked to the additional roles reimbursement scheme (ARRS), and years of underinvestment.”

The ARRS scheme was originally announced in January 2019 as part of the five-year GP contract agreed by the British Medical Association and NHS England, enabling primary care networks to claim funding for the recruitment of certain patient care roles, including pharmacists and pharmacy technicians.

Pharmacy bodies have been critical of ARRS, with the NPA saying it has “the unintended consequence of stripping away patient-facing professionals from community pharmacies, making pharmaceutical care less, rather than more, accessible overall”.

Between March 2020 and March 2025, the number of pharmacists in primary care networks grew from 153 pharmacists to 5,469 pharmacists, an increase of almost 3,500%, but growth has slowed dramatically in recent years^​3​.

Other factors

Despite the increase in hospital pharmacy teams on paper, Rob Connah, president of the Guild of Healthcare Pharmacists — which represents around 6,000 NHS pharmacists — says teams face other workforce pressures, including persistent vacancies and retainment challenges.

“Hospital pharmacy teams are supporting increasingly complex patient care, medicines optimisation, digital transformation programmes and have become integral parts of highly specialised multidisciplinary teams,” he says.

“Any increases in workforce numbers have often been offset by growing service demands, expanded clinical responsibilities and difficulties filling vacant posts, some of which have remained vacant for a prolonged period of time.

“Headcount and FTE figures alone may not capture persistent vacancy rates, challenges in retaining experienced staff, or reliance on temporary and locum workers to maintain essential services. This creates operational pressures even where overall workforce numbers appear relatively stable.” 

“There are obvious risks that sustained workforce pressures could impact service quality, staff wellbeing and the ability of pharmacy teams to deliver the full range of clinical services expected of them. Ensuring sufficient investment in the pharmacy workforce is essential to maintain safe, effective and patient-centred care as demand continues to grow,” he adds. 

While North Cheshire and Mersey NHS Foundation Trust has seen an increase in its pharmacy workforce over the past five years, a spokesperson says the trust has experienced “some recruitment challenges to band 7 level; therefore, a number of band 6 progression roles were recruited to support our workforce”.

What does this mean going forward?

With plans for care to move out of hospitals into the community, it seems the NHS may need to reset the balance of pharmacists before it can move forward with neighbourhood health.

“With continued pressure on pharmacy teams, sustained investment, training opportunities and long-term workforce planning remain essential,” says Doll.

The upcoming NHS workforce plan — originally promised for autumn 2025 — may address this, but until then it remains difficult to see how pharmacy can plan to deliver the government’s goals with such a varied picture across the profession.